Provider Demographics
NPI:1295029049
Name:KEENE, ANNA EVANS (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANNA
Middle Name:EVANS
Last Name:KEENE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:ANNA
Other - Middle Name:VICTORIA
Other - Last Name:EVANS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:5200 LEVERING MILL RD
Mailing Address - Street 2:
Mailing Address - City:APEX
Mailing Address - State:NC
Mailing Address - Zip Code:27539-3610
Mailing Address - Country:US
Mailing Address - Phone:910-734-7690
Mailing Address - Fax:
Practice Address - Street 1:1001 W WILLIAMS ST
Practice Address - Street 2:SUITE 105
Practice Address - City:APEX
Practice Address - State:NC
Practice Address - Zip Code:27502-3978
Practice Address - Country:US
Practice Address - Phone:919-362-7878
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-08
Last Update Date:2013-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9143122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist